TY - JOUR
T1 - Feasibility of diffusion-weighted magnetic resonance imaging in patients with juvenile idiopathic arthritis on 1.0-T open-bore MRI
AU - Barendregt, Anouk M
AU - Nusman, Charlotte M
AU - Hemke, Robert
AU - Lavini, Cristina
AU - Amiras, Dimitri
AU - Kuijpers, Taco W
AU - Maas, Mario
PY - 2015/12
Y1 - 2015/12
N2 - OBJECTIVE: To evaluate the feasibility of non-invasive diffusion-weighted imaging (DWI) of the knee of children with juvenile idiopathic arthritis (JIA) and, further, to analyze the apparent diffusion coefficient (ADC) levels to distinguish synovium from effusion.MATERIALS AND METHODS: Standard magnetic resonance imaging of the knee including post-contrast imaging was obtained in eight patients (mean age, 12 years 8 months, five females) using an open-bore magnetic resonance imaging system (1.0 T). In addition, axially acquired echo-planar DWI datasets (b-values 0, 50, and 600) were prospectively obtained and the diffusion images were post-processed into ADC50-600 maps. Two independent observers selected a region of interest (ROI) for both synovium and effusion using aligned post-contrast images as landmarks. Mann-Whitney U test was performed to compare ADC synovium and ADC effusion.RESULTS: DWI was successfully obtained in all patients. When data of both observers was combined, ADC synovium was lower than ADC effusion in the ROI in seven out of eight patients (median, 1.92 × 10(-3) mm(2)/s vs. 2.40 × 10(-3) mm(2)/s, p = 0.006, respectively). Similar results were obtained when the two observers were analyzed separately (observer 1: p = 0.006, observer 2: p = 0.04).CONCLUSIONS: In this pilot study, on a patient-friendly 1.0-T open-bore MRI, we demonstrated that DWI may potentially be a feasible non-invasive imaging technique in children with JIA. We could differentiate synovium from effusion in seven out of eight patients based on the ADC of synovium and effusion. However, to select synovium and effusion on DWI, post-contrast images were still a necessity.
AB - OBJECTIVE: To evaluate the feasibility of non-invasive diffusion-weighted imaging (DWI) of the knee of children with juvenile idiopathic arthritis (JIA) and, further, to analyze the apparent diffusion coefficient (ADC) levels to distinguish synovium from effusion.MATERIALS AND METHODS: Standard magnetic resonance imaging of the knee including post-contrast imaging was obtained in eight patients (mean age, 12 years 8 months, five females) using an open-bore magnetic resonance imaging system (1.0 T). In addition, axially acquired echo-planar DWI datasets (b-values 0, 50, and 600) were prospectively obtained and the diffusion images were post-processed into ADC50-600 maps. Two independent observers selected a region of interest (ROI) for both synovium and effusion using aligned post-contrast images as landmarks. Mann-Whitney U test was performed to compare ADC synovium and ADC effusion.RESULTS: DWI was successfully obtained in all patients. When data of both observers was combined, ADC synovium was lower than ADC effusion in the ROI in seven out of eight patients (median, 1.92 × 10(-3) mm(2)/s vs. 2.40 × 10(-3) mm(2)/s, p = 0.006, respectively). Similar results were obtained when the two observers were analyzed separately (observer 1: p = 0.006, observer 2: p = 0.04).CONCLUSIONS: In this pilot study, on a patient-friendly 1.0-T open-bore MRI, we demonstrated that DWI may potentially be a feasible non-invasive imaging technique in children with JIA. We could differentiate synovium from effusion in seven out of eight patients based on the ADC of synovium and effusion. However, to select synovium and effusion on DWI, post-contrast images were still a necessity.
KW - Adolescent
KW - Arthritis, Juvenile/pathology
KW - Child
KW - Diffusion Magnetic Resonance Imaging/methods
KW - Feasibility Studies
KW - Female
KW - Humans
KW - Image Enhancement/instrumentation
KW - Image Interpretation, Computer-Assisted/instrumentation
KW - Male
KW - Observer Variation
KW - Pilot Projects
KW - Reproducibility of Results
KW - Sensitivity and Specificity
KW - Synovial Fluid/cytology
KW - Synovial Membrane/pathology
U2 - 10.1007/s00256-015-2208-3
DO - 10.1007/s00256-015-2208-3
M3 - Article
C2 - 26205760
VL - 44
SP - 1805
EP - 1811
JO - Skeletal Radiology
JF - Skeletal Radiology
SN - 0364-2348
IS - 12
ER -